Surgical treatment of gastroesophageal reflux. Uses an abdominal approach; the distal esophagus is exposed and mobilized and then anchored to the hiatal crura to fashion the maximum length possible of esophagus in the abdominal cavity. The posterior pillars are reapproximated with sutures and the angle of His is restored by placing a suture from the fundus to the right crura. Sutures are then placed between the gastric fundus and the intraabdominal esophagus to effect anterior plication. Finally, 3 sutures are placed between the fundus and the undersurface of the left diaphragm to remove tension on the previously placed sutures.